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Difference between revisions of "Enrollment FHIR Resource Proposal"

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<!-- Identify the formal RIM mapping for the root concept of the resource.  The expectation is that the RIM mapping will be sufficiently precise so as to not overlap with any other resource definition. -->
 
<!-- Identify the formal RIM mapping for the root concept of the resource.  The expectation is that the RIM mapping will be sufficiently precise so as to not overlap with any other resource definition. -->
  
ActClass.COV in request mood.
+
Contract class with classCode of COV and moodCode of RQO.
  
 
==Resource appropriateness==
 
==Resource appropriateness==

Revision as of 01:43, 29 September 2014



Enrollment

Owning committee name

Financial Management

Contributing or Reviewing Work Groups

FHIR Resource Development Project Insight ID

994

Scope of coverage

Enrollment is used to request initial enrollment in and subsequent maintenance of coverage for one or more applicants/insureds under a public or private health insurance policy.

Enrollment records are the basis upon which verification of eligibility are made.

RIM scope

Contract class with classCode of COV and moodCode of RQO.

Resource appropriateness

Enrollment is used to request initial enrollment in and subsequent maintenance of coverage for one or more applicants/insureds under a public healthcare program or private health insurance policy.

Expected implementations

Referenced by CCDA. Referenced by CCDA in situations where coverage has is not yet effective, is effective, or has lapsed.

Content sources

  • v2 IN1, IN2, IN3 segments
  • v3 Eligibility and Coverage models
  • X12 270, 271, 834, 820
  • NCPDP


Example Scenarios

Initial, periodic, and yearly enrollment in public health programs (e.g., Medicaid/Medicare) or private health insurance in the individual or group insurance markets.

Resource Relationships

Timelines

Part of initial DSTU.

gForge Users

N/A